Provider Demographics
NPI:1720286354
Name:HARDEN, KAMITI UNDESA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAMITI
Middle Name:UNDESA
Last Name:HARDEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:537 WATER BIRCH WAY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-5819
Mailing Address - Country:US
Mailing Address - Phone:678-594-5021
Mailing Address - Fax:770-441-0299
Practice Address - Street 1:3271 HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-2384
Practice Address - Country:US
Practice Address - Phone:678-836-2111
Practice Address - Fax:770-441-0299
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADN0128971223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry